Disodium 2,2'-dithiobis ethane sulfonate (Dimesna) is currently in Phase I clinical trials in the United States and abroad as a toxicity reducing agent useful in ameliorating the toxicity of Cisplatin and other antineoplastic agents.
Sodium 2-mercaptoethane sulfonate (Mesna) is an approved drug in the United States and elsewhere for reducing the toxicity of certain antineoplastic alkylating agents, and has been shown to be particularly useful in reducing the acrolein mediated toxicity of cyclophosphamide and ifosfamide.
To date, derivatives of Mesna and Dimesna have been synthesized in which the sulfonate groups have been replaced with phosphonate groups, and the length of the alkane chain has been modified.
Dimesna is the preferred drug for the reduction of the toxicity of platinum complex and other antineoplastic agents because of its stability in the less reactive disulfide form while in the slightly basic environment of the blood.
In the kidney, Dimesna reduces to its monomer, and also forms various heteroconjugates. These species, along with Dimesna, substitute for the toxic hydroxy metabolites of Cisplatin, thus reducing Cisplatin induced nephrotoxicity, while not impairing the activity of the drug against the targeted cancer cells.